1
|
Keck JM, Viteri A, Schultz J, Fong R, Whitman C, Poush M, Martin M. New Agents Are Coming, and So Is the Resistance. Antibiotics (Basel) 2024; 13:648. [PMID: 39061330 PMCID: PMC11273847 DOI: 10.3390/antibiotics13070648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 07/10/2024] [Accepted: 07/11/2024] [Indexed: 07/28/2024] Open
Abstract
Antimicrobial resistance is a global threat that requires urgent attention to slow the spread of resistant pathogens. The United States Centers for Disease Control and Prevention (CDC) has emphasized clinician-driven antimicrobial stewardship approaches including the reporting and proper documentation of antimicrobial usage and resistance. Additional efforts have targeted the development of new antimicrobial agents, but narrow profit margins have hindered manufacturers from investing in novel antimicrobials for clinical use and therefore the production of new antibiotics has decreased. In order to combat this, both antimicrobial drug discovery processes and healthcare reimbursement programs must be improved. Without action, this poses a high probability to culminate in a deadly post-antibiotic era. This review will highlight some of the global health challenges faced both today and in the future. Furthermore, the new Infectious Diseases Society of America (IDSA) guidelines for resistant Gram-negative pathogens will be discussed. This includes new antimicrobial agents which have gained or are likely to gain FDA approval. Emphasis will be placed on which human pathogens each of these agents cover, as well as how these new agents could be utilized in clinical practice.
Collapse
Affiliation(s)
- J. Myles Keck
- Department of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Alina Viteri
- Department of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | | | - Rebecca Fong
- Department of Pharmacy, Central Arkansas Veterans Healthcare System, Little Rock, AR 72205, USA
| | - Charles Whitman
- Department of Pharmacy, Central Arkansas Veterans Healthcare System, Little Rock, AR 72205, USA
| | - Madeline Poush
- Department of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Marlee Martin
- Department of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| |
Collapse
|
2
|
Haque S, Ahmed A, Islam N, Haque FKM. High Prevalence of Multidrug-Resistant Bacteria in the Trachea of Intensive Care Units Admitted Patients: Evidence from a Bangladeshi Hospital. Antibiotics (Basel) 2024; 13:62. [PMID: 38247621 PMCID: PMC10812536 DOI: 10.3390/antibiotics13010062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 10/23/2023] [Accepted: 10/25/2023] [Indexed: 01/23/2024] Open
Abstract
Recent research has shown that antibiotic-resistant microorganisms are becoming more prevalent in intensive care units (ICUs) at an exponential rate. Patients in the ICU can get infected by pathogens due to invasive operation procedures and critical health conditions. This study primarily emphasized tracheal samples from ICU patients due to their reliance on ventilators, increasing their susceptibility to Ventilator-Associated Pneumonia (VAP). Moreover, the rise of multidrug-resistant (MDR) pathogens makes treatment strategies more challenging for these patients. In this study, we tested 200 tracheal specimens to determine the prevalence of microorganisms and analyzed the antibiotic susceptibility of these isolates against regular antibiotics, including 4th generation drugs. Among the 273 isolates, 81% were gram-negative bacteria, 10% were gram-positive bacteria, and 9% were fungi. The most prevalent gram-negative bacteria were Acinetobacter spp. (34%), Klebsiella spp. (22%), Pseudomonas spp. (14%), and Escherichia coli (9.2%). The most prevalent gram-positive bacteria were Staphylococcus aureus (5.9%), and the fungi were Candida spp. (7.3%). Among the most prevalent bacteria, except Staphylococcus aureus isolates, around 90% were resistant to multiple drugs, whereas 60% of Acinetobacter spp. and Pseudomonas spp. were extensively drug resistant. Sensitivity analysis against the gram-negative and gram-positive drug panel using a one-way ANOVA test followed by Tukey's post hoc test showed that in the in vitro assay, colistin was the most effective antibiotic against all gram-negative bacteria. In contrast, linezolid, vancomycin, and fusidic acid were most effective against all gram-positive bacteria. Regular monitoring of nosocomial infections and safe management of highly resistant bacteria can help prevent future pandemics.
Collapse
Affiliation(s)
- Sabrina Haque
- Microbiology Program, Department of Mathematics and Natural Sciences, BRAC University, Dhaka 1212, Bangladesh; (S.H.); (A.A.)
| | - Akash Ahmed
- Microbiology Program, Department of Mathematics and Natural Sciences, BRAC University, Dhaka 1212, Bangladesh; (S.H.); (A.A.)
| | - Nazrul Islam
- IBN SINA Diagnostic and Imaging Center, Dhaka 1209, Bangladesh;
| | - Fahim Kabir Monjurul Haque
- Microbiology Program, Department of Mathematics and Natural Sciences, BRAC University, Dhaka 1212, Bangladesh; (S.H.); (A.A.)
| |
Collapse
|
3
|
Mohamed HMA, Abd-Elhafeez HH, Al-Jabr OA, El-Zamkan MA. Characterization of Acinetobacter baumannii Isolated from Raw Milk. BIOLOGY 2022; 11:biology11121845. [PMID: 36552354 PMCID: PMC9775129 DOI: 10.3390/biology11121845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/10/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
Acinetobacter baumannii (A. baumannii) is an opportunistic pathogen associated with nosocomial infections. In this study, 100 raw milk samples were collected from Qena, Egypt, and subjected to conventional and molecular assays to determine the presence of A. baumannii and investigate their antimicrobial resistance and biofilm formation. Our findings revealed that, among the 100 samples, Acinetobacter spp. were found in 13 samples based on CHROM agar results. We further characterized them using rpoB and 16S-23SrRNA sequencing and gyrB multiplex PCR analysis and confirmed that 9 out of the 13 Acinetobacter spp. isolates were A. baumannii and 4 were other species. The A. baumannii isolates were resistant to β-lactam drugs, including cefotaxime (44%), ampicillin-sulbactam and levofloxacin (33.3% for each), imipenem, meropenem and aztreonam (22.2% for each). We observed different antimicrobial resistance patterns, with a multi-antibiotic resistant (MAR) index ranging from 0.2 to 0.3. According to the PCR results, blaOXA-51 and blaOXA-23 genes were amplified in 100% and 55.5% of the A. baumannii isolates, respectively, while the blaOXA-58 gene was not amplified. Furthermore, the metallo-β-lactamases (MBL) genes blaIMP and blaNDM were found in 11.1% and 22.2% of isolates, respectively, while blaVIM was not amplified. Additionally, eight A. baumannii isolates (88.8%) produced black-colored colonies on Congo red agar, demonstrating their biofilm production capacity. These results showed that, besides other foodborne pathogens, raw milk should also be examined for A. baumannii, which could be a public health concern.
Collapse
Affiliation(s)
- Hams M. A. Mohamed
- Department of Microbiology, Faculty of Veterinary Medicine, South Valley University, Qena 83523, Egypt
| | - Hanan H. Abd-Elhafeez
- Department of Cells and Tissues, Faculty of Veterinary Medicine, Assiut University, Assiut 71526, Egypt
- Correspondence:
| | - Omar A. Al-Jabr
- Department of Microbiology, College of Veterinary Medicine, King Faisal University, P.O. Box 400, Al-Ahsa 31982, Saudi Arabia
| | - Mona A. El-Zamkan
- Department of Food Hygiene and Control, Faculty of Veterinary Medicine, South Valley University, Qena 83523, Egypt
| |
Collapse
|
4
|
Eksin E. An electrochemical assay for sensitive detection of Acinetobacter baumannii gene. Talanta 2022; 249:123696. [PMID: 35749906 DOI: 10.1016/j.talanta.2022.123696] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/12/2022] [Accepted: 06/14/2022] [Indexed: 11/25/2022]
Abstract
A new genosensor, which allows sensitive and selective detection of Acinetobacter baumannii gene sequence was developed herein. In this assay, capture probe of Acinetobacter baumannii was immobilized on the surface of chitosan modified single-use pencil graphite electrodes (c-PGEs) to obtain Acinetobacter baumannii genosensor. Then, Acinetobacter baumannii target DNA sequence was recognized after solid-state hybridization on c-PGE genosensor by measuring guanine signal via differential pulse voltammetry (DPV). In order to improve hybridization efficiency, experimental parameters affecting all assay steps are studied and the analytical performance of the genosensor was tested. The low limit of detection (LOD) for Acinetobacter baumannii target DNA sequence was obtained as 1.86 nM with developed genosensor. The selectivity of the proposed assay was then tested in the presence of 1-base mismatch, or two different type of non-complementary sequences and no interference effect was observed. The proposed electrochemical assay protocol is easy, convenient, and rapid which can be a decent alternative to existing methods.
Collapse
Affiliation(s)
- Ece Eksin
- Biomedical Device Technology Program, Vocational School of Health Services, Izmir Democracy University, Izmir 35140, Turkey; Department of Analytical Chemistry, Faculty of Pharmacy, Ege University, Izmir 35100, Turkey.
| |
Collapse
|
5
|
Uzoukwu EU, Phandanouvong-Lozano V, Usman H, Sfeir C, Niepa THR. Droplet-based microsystems as novel assessment tools for oral microbial dynamics. Biotechnol Adv 2022; 55:107903. [PMID: 34990774 DOI: 10.1016/j.biotechadv.2021.107903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 12/03/2021] [Accepted: 12/30/2021] [Indexed: 12/11/2022]
Abstract
The human microbiome comprises thousands of microbial species that live in and on the body and play critical roles in human health and disease. Recent findings on the interplay among members of the oral microbiome, defined by a personalized set of microorganisms, have elucidated the role of bacteria and yeasts in oral health and diseases including dental caries, halitosis, and periodontal infections. However, the majority of these studies rely on traditional culturing methods which are limited in their ability of replicating the oral microenvironment, and therefore fail to evaluate key microbial interactions in microbiome dynamics. Novel culturing methods have emerged to address this shortcoming. Here, we reviewed the potential of droplet-based microfluidics as an alternative approach for culturing microorganisms and assessing the oral microbiome dynamics. We discussed the state of the art and recent progress in the field of oral microbiology. Although at its infancy, droplet-based microtechnology presents an interesting potential for elucidating oral microbial dynamics and pathophysiology. We highlight how new findings provided by current microfluidic-based methodologies could advance the investigation of the oral microbiome. We anticipate that our work involving the droplet-based microfluidic technique with a semipermeable membrane will lay the foundations for future microbial dynamics studies and further expand the knowledge of the oral microbiome and its implication in oral health.
Collapse
Affiliation(s)
| | | | - Huda Usman
- Department of Chemical and Petroleum Engineering, University of Pittsburgh, PA, USA
| | - Charles Sfeir
- Department of Bioengineering, University of Pittsburgh, PA, USA; Department of Periodontics and Preventive Dentistry, University of Pittsburgh, PA, USA; Department of Oral Biology, University of Pittsburgh, PA, USA; The Center for Craniofacial Regeneration, University of Pittsburgh, PA, USA; The McGowan Institute for Regenerative Medicine, University of Pittsburgh, PA, USA
| | - Tagbo H R Niepa
- Department of Chemical and Petroleum Engineering, University of Pittsburgh, PA, USA; Department of Bioengineering, University of Pittsburgh, PA, USA; Department of Civil and Environmental Engineering, University of Pittsburgh, PA, USA; Department of Mechanical Engineering and Materials Science, University of Pittsburgh, PA, USA; Center for Medicine and the Microbiome, University of Pittsburgh, PA, USA; The McGowan Institute for Regenerative Medicine, University of Pittsburgh, PA, USA.
| |
Collapse
|
6
|
Al-Timimi Z. Evaluation of the Significance of Constant Laser Therapy, 532 nm, in Various Exposure Times on the Healing Process of Wounds Infected by Acinetobacter baumannii. INT J LOW EXTR WOUND 2021; 21:640-646. [PMID: 33393388 DOI: 10.1177/1534734620984039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Many considerable investigations focused on the stimulation of therapeutic manners of infected injuries in mice. The exaggerated pathogens that induced wounds were gram-positive like staphylococcal and gram-negative, for example, Pseudomonas aeuroginosa and Acinetobacter baumannii. Acinetobacter can generate a scale range of an infection that may be received in a hospital or any wellness concern facility. In order to know the significance of laser 532 nm with a constant irradiance at various exposure times on the healing process of wounds infected by Acinetobacter baumannii, this study was performed on the BALB/C mice. An elliptical full-thickness skin injury was made on the backside of 45 adult female (BALB/C) mice. Injuries were affected via Acinetobacter baumannii and were randomly assigned into 3 groups. Semiconductor diode continuous wave laser, λ = 532 nm, with output power 40 mW was used. The power density was 5.71 mW/cm2, while the fluencies were 1.7 J/cm2 and 5.14 J/cm2. Fifteen mice were classified according to the times of irradiation. The first group was infected and presented as control, without irradiation. The second group was infected and irradiated for 5 minutes. The third group, likewise, was infected but irradiated for 15 minutes. All groups were subdivided according to the following period, 3, 5, and 10 days, after irradiation and the animals were killed after the treatment. Wound healing was made by measuring the rate of wound closure and histopathological evaluation. The study determined that 532 nm laser therapy had an obvious and positive influence on the healing of infected wounds with fluence (5.14 J/cm2).
Collapse
|
7
|
Farouk F, El Shimy R, Abdel-Motaleb A, Essam S, Azzazy HM. Detection of Acinetobacter baumannii in fresh produce using modified magnetic nanoparticles and PCR. Anal Biochem 2020; 609:113890. [DOI: 10.1016/j.ab.2020.113890] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 07/10/2020] [Accepted: 07/23/2020] [Indexed: 12/19/2022]
|
8
|
Benoit T, Cloutier M, Schop R, Lowerison MW, Khan IUH. Comparative assessment of growth media and incubation conditions for enhanced recovery and isolation of Acinetobacter baumannii from aquatic matrices. J Microbiol Methods 2020; 176:106023. [PMID: 32795636 DOI: 10.1016/j.mimet.2020.106023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/16/2020] [Accepted: 07/24/2020] [Indexed: 11/16/2022]
Abstract
Acinetobacter baumannii causes serious multidrug resistant nosocomial infections around the world. This comprehensive comparative study was designed to assess the effect of temperature (30, 37 and 42 °C), incubation (aerobic and microaerobic) condition and selective [CHROMagar Acinetobacter (CHR) and Leeds Acinetobacter Medium (LAM)] and non-selective [Modified Karmali Agar (MKA)] growth media on the enhanced recovery of A. baumannii from a variety of water (agricultural, recreational, raw drinking intake source, pre-chlorinated and post-chlorinated wastewater effluent) samples spiked with a known number of A. baumannii cells. After spiking each water type with a known number of cells in 10 mL volume, the sample was passed through a membrane filter (pore size 0.45 μm) and filters were placed on different selective media plates and subjected to incubate at various incubation conditions. The results reported in this study show that for all water types tested (except post-chlorinated wastewater effluent), LAM was the most effective selective growth medium in combination with variable temperature and incubation conditions for yielding high recovery rates of A. baumannii cells. Overall, A. baumannii showed that it has a high adaptive capacity to grow on selective and non-selective growth media at different temperature and incubation conditions. The data described in this study suggest that no single incubation condition and growth media would efficiently recover A. baumannii from all environmental water types tested. This data also indicate that selective growth media and incubation condition can significantly affect the recovery of A. baumannii. Differences in recovery of A. baumannii observed in this study which appeared to be dependent on the temperature and environmental characteristics of incubation as well as the sample type, suggest the need for caution when comparing recovery using different protocols.
Collapse
Affiliation(s)
- Thomas Benoit
- Ottawa Research and Development Centre (ORDC), Agriculture and Agri-Food Canada, Ottawa, ON, Canada; Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada
| | - Michel Cloutier
- Ottawa Research and Development Centre (ORDC), Agriculture and Agri-Food Canada, Ottawa, ON, Canada
| | - Rhonda Schop
- Ontario Ministry of the Environment, Conservation and Parks, Etobioke, ON, Canada
| | | | - Izhar U H Khan
- Ottawa Research and Development Centre (ORDC), Agriculture and Agri-Food Canada, Ottawa, ON, Canada.
| |
Collapse
|
9
|
Bio-assay of Acintobacter baumannii using DNA conjugated with gold nano-star: A new platform for microorganism analysis. Enzyme Microb Technol 2020; 133:109466. [PMID: 31874682 DOI: 10.1016/j.enzmictec.2019.109466] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 11/07/2019] [Accepted: 11/08/2019] [Indexed: 11/18/2022]
|
10
|
Failure to Communicate: Transmission of Extensively Drug-Resistant bla OXA-237-Containing Acinetobacter baumannii-Multiple Facilities in Oregon, 2012-2014. Infect Control Hosp Epidemiol 2017; 38:1335-1341. [PMID: 28870269 DOI: 10.1017/ice.2017.189] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To determine the scope, source, and mode of transmission of a multifacility outbreak of extensively drug-resistant (XDR) Acinetobacter baumannii. DESIGN Outbreak investigation. SETTING AND PARTICIPANTS Residents and patients in skilled nursing facilities, long-term acute-care hospital, and acute-care hospitals. METHODS A case was defined as the incident isolate from clinical or surveillance cultures of XDR Acinetobacter baumannii resistant to imipenem or meropenem and nonsusceptible to all but 1 or 2 antibiotic classes in a patient in an Oregon healthcare facility during January 2012-December 2014. We queried clinical laboratories, reviewed medical records, oversaw patient and environmental surveillance surveys at 2 facilities, and recommended interventions. Pulsed-field gel electrophoresis (PFGE) and molecular analysis were performed. RESULTS We identified 21 cases, highly related by PFGE or healthcare facility exposure. Overall, 17 patients (81%) were admitted to either long-term acute-care hospital A (n=8), or skilled nursing facility A (n=8), or both (n=1) prior to XDR A. baumannii isolation. Interfacility communication of patient or resident XDR status was not performed during transfer between facilities. The rare plasmid-encoded carbapenemase gene bla OXA-237 was present in 16 outbreak isolates. Contact precautions, chlorhexidine baths, enhanced environmental cleaning, and interfacility communication were implemented for cases to halt transmission. CONCLUSIONS Interfacility transmission of XDR A. baumannii carrying the rare blaOXA-237 was facilitated by transfer of affected patients without communication to receiving facilities. Infect Control Hosp Epidemiol 2017;38:1335-1341.
Collapse
|
11
|
Nutman A, Lerner A, Schwartz D, Carmeli Y. Evaluation of carriage and environmental contamination by carbapenem-resistant Acinetobacter baumannii. Clin Microbiol Infect 2016; 22:949.e5-949.e7. [DOI: 10.1016/j.cmi.2016.08.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 08/14/2016] [Accepted: 08/15/2016] [Indexed: 10/21/2022]
|
12
|
Rasoulinejad S, Gargari SLM. Aptamer-nanobody based ELASA for specific detection of Acinetobacter baumannii isolates. J Biotechnol 2016; 231:46-54. [PMID: 27234880 DOI: 10.1016/j.jbiotec.2016.05.024] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 04/12/2016] [Accepted: 05/19/2016] [Indexed: 11/26/2022]
Abstract
Acinetobacter baumannii has turned into an important threat in nosocomial outbreak infections and multidrug resistance leading to high mortality rates in the 21st century. In recent years its mortality has increased by 15% which in part could be due to lack of a rapid and sensitive diagnostic test. In this work we introduced a new detection test for A. baumannii with two highly specific aptamer and nanobody molecules. High binding affinity DNA oligonucleotide aptamers toward A. baumannii were selected through 12 rounds of whole cell System Evolution of Ligands by EXponential enrichment process (SELEX). The SELEX procedures was monitored by flow cytometry. The dissociation constant and binding efficiency of the selected aptamer Aci49 was 7.547±1:353pM and 47.50%, respectively. A sandwich enzyme linked aptamer sorbent assay (ELASA) was designed with the biotinylated Aci49 aptamer and our previously developed nanobody against biofilm associated protein (Bap). The assay system was optimized with A. baumannii (ATCC 19606) and 47 clinical isolates of A. baumannii were tested. The threshold of detection in sandwich ELASA process was10(3) CFU/ml. The sensitivity of test toward the clinical isolates was 95.47%. Our results reveal that the sandwich ELASA is sensitive and specific enough for the rapid detection of A. baumannii from clinical isolates.
Collapse
|
13
|
Carvalheira A, Ferreira V, Silva J, Teixeira P. Enrichment of Acinetobacter spp. from food samples. Food Microbiol 2016; 55:123-7. [DOI: 10.1016/j.fm.2015.11.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 10/31/2015] [Accepted: 11/06/2015] [Indexed: 10/22/2022]
|
14
|
CHROMagar Acinetobacter medium for detection of carbapenemase-producing Acinetobacter spp. strains from spiked stools. Diagn Microbiol Infect Dis 2015; 83:234-6. [DOI: 10.1016/j.diagmicrobio.2015.06.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 06/12/2015] [Accepted: 06/24/2015] [Indexed: 11/19/2022]
|
15
|
Ghaith DM, Hassan RM, Hasanin AM. Rapid identification of nosocomial Acinetobacter baumannii isolated from a surgical intensive care unit in Egypt. Ann Saudi Med 2015; 35:440-4. [PMID: 26657227 PMCID: PMC6074475 DOI: 10.5144/0256-4947.2015.440] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The rapid and accurate identification of nosocomial clinical isolates is the first essential step in investigating nosocomial outbreaks. We aimed to evaluate the performance of MDR-CHROMagar Acinetobacter versus matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) in rapid detection of nosocomial Acinetobacter baumannii isolated from patients admitted to the surgical intensive care unit (SICU) of Kasr Alainy- Cairo University. METHODS Over a period of 9 months from January 2014 until September 2014, 234 samples were collected. All samples were directly cultured on MDR-CHROMagar Acinetobacter media. MALDI-TOF MS was used to identify all non-lactose fermenting colonies on conventional media. Confirmation of species identification was done by detecting the blaOXA-51 like gene by PCR. RESULTS Statistical evaluation of MDR-CHROMagar Acinetobacter against blaOXA-51 like PCR as the reference method for identification of A baumannii showed a sensitivity of 100% (95% confidence interval [CI]: 93.36% to 100%), specificity 98.8% (95% confidence interval [CI]: 96.04% to 99.68%), positive predictive value 96.4% (95%CI: 86.61% to 99.37%), negative predictive value 100% (95% CI: 97.36% to 100%). The statistical evaluation of MALDI-TOF against blaOXA-51 PCR was 100% concordance. CONCLUSION MALDI-TOF MS was more specific than CHROMagar in identifying Acinetobacter spp and allowed further identification of non-A Baumannii species such as A hemolyticus and A nosocomialis, which are less common Acinetobacter spp involved in hospital-acquired infections.
Collapse
Affiliation(s)
- Doaa Mohammad Ghaith
- Dr. Doaa Ghaith, Clinical and Chemical Pathology Department,, Faculty of Medicine, Cairo University,, 1 Al-Saray St. Al-Manial, Cairo 11559,, Egypt, T: (+202) 23654480, F: (+202) 23641687,
| | | | | |
Collapse
|
16
|
Task force on management and prevention of Acinetobacter baumannii infections in the ICU. Intensive Care Med 2015; 41:2057-75. [DOI: 10.1007/s00134-015-4079-4] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 09/22/2015] [Indexed: 12/16/2022]
|
17
|
Cheng VCC, Chen JHK, So SYC, Wong SCY, Yan MK, Chau PH, Lee WM, To KKW, Chan JFW, Hung IFN, Ho PL, Yuen KY. Use of fluoroquinolones is the single most important risk factor for the high bacterial load in patients with nasal and gastrointestinal colonization by multidrug-resistant Acinetobacter baumannii. Eur J Clin Microbiol Infect Dis 2015; 34:2359-66. [PMID: 26373714 DOI: 10.1007/s10096-015-2489-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 09/03/2015] [Indexed: 10/23/2022]
Abstract
Gastrointestinal colonization by carbapenem-resistant Acinetobacter baumannii (CRAB) and multidrug-resistant Acinetobacter baumannii (MRAB) provides an important reservoir for clinical infections and hospital outbreaks. We conducted a 7-month study in a 3200-bed healthcare network to investigate the prevalence of gastrointestinal colonization of CRAB and MRAB in Hong Kong. Between 1 June and 31 December 2014, a total of 17,760 fecal specimens from 9469 patients were screened. Testing showed that 340 (1.9%) specimens from 224 (2.6%) patients were CRAB-positive, which included 70 (0.39%) MRAB-positive specimens from 54 (0.57%) patients. The presence of wound or ulcer, use of broad-spectrum antibiotics in the preceding 6 months, and residence in elderly homes are independent risk factors for gastrointestinal colonization of CRAB. Quantitative bacterial counts in various body sites (rectal, nasal, axilla, wound, catheterized urine, if available) were performed in 33 (61.1%) of 54 MRAB patients. Ten (30.3%) and 8 (24.2%) patients had high bacterial load (defined as over 3 log10) in rectal and nasal swabs, with a median of 5.04 log10 cfu/ml of rectal swab and 4.89 log10 cfu/ml of nasal swab in saline diluent, respectively. Nine (81.8%) of 11 patients with wounds had high bacterial load in wound swabs, with a median of 5.62 log10 cfu/ml. Use of fluoroquinolones 6 months before admission was the only significant factor associated with high bacterial load in nasal and rectal swabs. With the implementation of directly observed hand hygiene before meals and medications to all conscious hospitalized patients, no hospital outbreaks were observed during our study period.
Collapse
Affiliation(s)
- V C C Cheng
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China.,Infection Control Team, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - J H K Chen
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - S Y C So
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - S C Y Wong
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - M K Yan
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - P H Chau
- School of Nursing, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - W M Lee
- Infection Control Team, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - K K W To
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - J F W Chan
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - I F N Hung
- Department of Medicine, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - P L Ho
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - K Y Yuen
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China.
| |
Collapse
|
18
|
Helal S, El Anany M, Ghaith D, Rabeea S. The Role of MDR-Acinetobacter baumannii in Orthopedic Surgical Site Infections. Surg Infect (Larchmt) 2015; 16:518-22. [PMID: 26114551 DOI: 10.1089/sur.2014.187] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Gram-positive microorganisms were the main causative organisms of orthopedic surgical site infections (SSI); however the rising incidence of multiple drug resistant Acinetobacter baumannii (MDR-AB) infections in orthopedic operations causes a great concern because of their limited array of therapeutic options. OBJECTIVE Our objective was to remark the changing microbiology in orthopedic SSI and to evaluate the MDR CHROMagar Acinetobacter media for screening of MDR-AB. METHODS Aspirated pus samples were collected from infected wounds of 100 patients in the orthopedics unit of El-Helal Hospital, samples were cultured on conventional media and MDR CHROMagar Acinetobacter media, the reveled MDR-AB colonies were subjected to polymerase chain reaction (PCR) to detect blaOXA-51 like gene. RESULTS Out of 100 infected wounds SSI cases represented 90/100 (90%) according to CDC 2013 definitions. Staphylococcus aureus was the dominant organism 40/90 (44.4%) (P value 0.038), all S. aureus isolates were methicillin-resistant Staphylococcus aureus (MRSA), followed by Klebsiella pneumoniae 22/90 (24.44%) and Acinetobacter 15/90 (16.67%). Implant was highly associated with SSI cases 80/90 (89%). Also, prolonged hospital stay>7 d was significantly associated with SSI 69/90 (77%) (p=0.001). CONCLUSION Staphylococcus aureus was the main causative organism of orthopedic SSI (44.4%), whereas A. baumannii represented only (16.67%) of the causative organisms. MDR Acinetobacter CHROMagar reduced the turnaround time for screening of MDR-AB.
Collapse
Affiliation(s)
- Sohier Helal
- Clinical and Chemical Pathology Department, Cairo University , Cairo, Egypt
| | - Mervat El Anany
- Clinical and Chemical Pathology Department, Cairo University , Cairo, Egypt
| | - Doaa Ghaith
- Clinical and Chemical Pathology Department, Cairo University , Cairo, Egypt
| | - Samar Rabeea
- Clinical and Chemical Pathology Department, Cairo University , Cairo, Egypt
| |
Collapse
|
19
|
Infrequent air contamination with Acinetobacter baumannii of air surrounding known colonized or infected patients. Infect Control Hosp Epidemiol 2015; 36:830-2. [PMID: 25825865 DOI: 10.1017/ice.2015.68] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Using a validated air sampling method we found Acinetobacter baumannii in the air surrounding only 1 of 12 patients known to be colonized or infected with A. baumannii. Patients' closed-circuit ventilator status, frequent air exchanges in patient rooms, and short sampling time may have contributed to this low burden.
Collapse
|
20
|
Assessing the Burden of Acinetobacter baumannii in Maryland: A Statewide Cross-Sectional Period Prevalence Survey. Infect Control Hosp Epidemiol 2015. [DOI: 10.1017/s0195941700031489] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Objective.To determine the prevalence ofAcinetobacter baumannii, an important healthcare-associated pathogen, among mechanically ventilated patients in Maryland.Design.The Maryland MDRO Prevention Collaborative performed a statewide cross-sectional active surveillance survey of mechanically ventilated patients residing in acute care and long-term care (LTC) facilities. Surveillance cultures (sputum and perianal) were obtained from all mechanically ventilated inpatients at participating facilities during a 2-week period.Setting.All healthcare facilities in Maryland that provide care for mechanically ventilated patients were invited to participate.Patients.Mechanically ventilated patients, known to be at high risk for colonization and infection withA. baumannii, were included.Results.Seventy percent (40/57) of all eligible healthcare facilities participated in the survey, representing both acute care (n= 30) and LTC (n= 10) facilities in all geographic regions of Maryland. Surveillance cultures were obtained from 92% (358/390) of eligible Patients.A. baumanniiwas identified in 34% of all mechanically ventilated patients in Maryland; multidrug-resistantA. baumanniiwas found in 27% of all Patients.A. baumanniiwas detected in at least 1 patient in 49% of participating facilities; 100% of LTC facilities had at least 1 patient with A.baumannii, compared with 31% of acute care facilities.A. baumanniiwas identified from all facilities in which 10 or more patients were sampled.Conclusions.A.baumanniiis common among mechanically ventilated patients in both acute care and LTC facilities throughout Maryland, with a high proportion of isolates demonstrating multidrug resistance.
Collapse
|
21
|
Laboratory evaluation of different agar media for isolation of carbapenem-resistant Acinetobacter spp. Eur J Clin Microbiol Infect Dis 2014; 33:1909-13. [DOI: 10.1007/s10096-014-2159-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 05/06/2014] [Indexed: 10/25/2022]
|
22
|
Abbott I, Cerqueira GM, Bhuiyan S, Peleg AY. Carbapenem resistance inAcinetobacter baumannii: laboratory challenges, mechanistic insights and therapeutic strategies. Expert Rev Anti Infect Ther 2014; 11:395-409. [DOI: 10.1586/eri.13.21] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
23
|
Song W, Lee J, Kim TK, Park MJ, Kim HS, Kim JS. Modified CHROMagar Acinetobacter medium for direct detection of multidrug-resistant Acinetobacter strains in nasal and rectal swab samples. Ann Lab Med 2013; 33:193-5. [PMID: 23667846 PMCID: PMC3646194 DOI: 10.3343/alm.2013.33.3.193] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Revised: 12/11/2012] [Accepted: 02/16/2013] [Indexed: 11/19/2022] Open
Abstract
This study aimed to investigate whether CHROMagar Acinetobacter medium (CHROMagar, France) in combination with an antimicrobial supplement (modified CHROMagar Acinetobacter; CHROMagar, France) can be used for detecting and isolating multidrug-resistant Acinetobacter species (MRA) in nasal and rectal surveillance cultures. Nasal and rectal swab samples were collected from patients in an intensive care unit at a teaching hospital. The samples were used to inoculate modified CHROMagar Acinetobacter plates, which were examined after 24 and 48 hr of incubation at 37℃. Their susceptibility against the antimicrobial agents meropenem, imipenem, ciprofloxacin, and amikacin was analyzed using the Etest (bioMerieux, France). A total of 406 paired samples (406 nasal swabs and 406 rectal swabs) were obtained from 226 patients, and 120 samples (28 nasal and 28 rectal cultures, 47 nasal cultures only, and 17 rectal cultures only) yielded MRA. Seventy-five MRA isolates (18.5%) were recovered from the 406 nasal samples, and 45 MRA isolates (11.1%) were recovered from the 406 rectal samples. Of the 120 MRA isolates, 3 (2.5%) were detected only after 48 hr of incubation. The use of modified CHROMagar Acinetobacter together with nasal and rectal swabs and 1-day incubation is an effective surveillance tool for detecting MRA colonization.
Collapse
Affiliation(s)
- Wonkeun Song
- Department of Laboratory Medicine, Hallym University College of Medicine, Chuncheon, Korea.
| | | | | | | | | | | |
Collapse
|
24
|
Barsoumian A, Calvano T, Markelz AE, Cassidy R, Murray CK, Beckius ML, Mende K, Akers KS. Variations of CHROMagar Acinetobacter to detect imipenem-resistant Acinetobacter baumannii–calcoaceticus complex. ACTA ACUST UNITED AC 2013; 45:446-52. [DOI: 10.3109/00365548.2013.759270] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
25
|
Thom KA, Maragakis LL, Richards K, Johnson JK, Roup B, Lawson P, Harris AD, Fuss EP, Pass MA, Blythe D, Perencevich EN, Wilson L. Assessing the burden of Acinetobacter baumannii in Maryland: a statewide cross-sectional period prevalence survey. Infect Control Hosp Epidemiol 2012; 33:883-8. [PMID: 22869261 DOI: 10.1086/667376] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To determine the prevalence of Acinetobacter baumannii, an important healthcare-associated pathogen, among mechanically ventilated patients in Maryland. DESIGN The Maryland MDRO Prevention Collaborative performed a statewide cross-sectional active surveillance survey of mechanically ventilated patients residing in acute care and long-term care (LTC) facilities. Surveillance cultures (sputum and perianal) were obtained from all mechanically ventilated inpatients at participating facilities during a 2-week period. SETTING All healthcare facilities in Maryland that provide care for mechanically ventilated patients were invited to participate. PATIENTS Mechanically ventilated patients, known to be at high risk for colonization and infection with A. baumannii, were included. RESULTS Seventy percent (40/57) of all eligible healthcare facilities participated in the survey, representing both acute care ([Formula: see text]) and LTC ([Formula: see text]) facilities in all geographic regions of Maryland. Surveillance cultures were obtained from 92% (358/390) of eligible patients. A. baumannii was identified in 34% of all mechanically ventilated patients in Maryland; multidrug-resistant A. baumannii was found in 27% of all patients. A. baumannii was detected in at least 1 patient in 49% of participating facilities; 100% of LTC facilities had at least 1 patient with A. baumannii, compared with 31% of acute care facilities. A. baumannii was identified from all facilities in which 10 or more patients were sampled. CONCLUSIONS A. baumannii is common among mechanically ventilated patients in both acute care and LTC facilities throughout Maryland, with a high proportion of isolates demonstrating multidrug resistance.
Collapse
Affiliation(s)
- Kerri A Thom
- University of Maryland School of Medicine, Baltimore, Maryland, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Comparison of swab and sponge methodologies for identification of Acinetobacter baumannii from the hospital environment. J Clin Microbiol 2012; 50:2140-1. [PMID: 22461673 DOI: 10.1128/jcm.00448-12] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The ideal sampling method for identification of Acinetobacter baumannii from the health care environment is unknown. In this study, we sampled 145 surfaces in the rooms of patients with known A. baumannii colonization/infection, comparing two methods: swab and sponge. The sensitivity of the swab method was 87%, while the sensitivity of the sponge method was 75%. Given the comparable results, use of the cheaper and less laborious swab technique is acceptable and may be preferable.
Collapse
|